Last update: June 12, 2019

Ephedrine

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

An alkaloid derived from ephedra.
It has sympathomimetic properties with direct and indirect effects on adrenergic receptors.
Used parenterally to treat hypotension derived from spinal or epidural anesthesia due to its peripheral vasoconstrictor effects and improvement of heart tone.
Used orally as a bronchodilator and nasal decongestant mixed in preparations for colds, bronchitis and asthma.
Used illegaly as a psychostimulant and for weight loss, with serious health risks (van der Hoof 2002, Gruber 1998).

Since the last update we have not found published data on its excretion in breast milk.

Its large volume of distribution makes it unlikely it will pass into milk in significant amounts.

After a cesarean section with epidural anesthesia and use of ephedrine there were no side effects in 100 newborns; the time of initial breastfeeding was not delayed with respect to newborns after cesareans under general anesthesia (Havas 2013). The use of ephedrine during delivery or cesarean section is not contraindicated with the early initiation of breastfeeding: as well as the unlikely excretion in breast milk there is a low amount of colostrum obtained by the newborn in the first hours of life.

It may be desirable to minimize the continued use of oral preparations for colds/bronchitis which contain ephedrine since a case of crying, irritability and insomnia has been reported in a 3-month-old infant whose mother was taking a medication containing d-isoephedrine and dexbrompheniramine (Mortimer 1977).
Simple preparations (a single active ingredient per drug) are preferable and even more so during breastfeeding.

Abusive use as a psychostimulant or antiobesity product entails serious risks to the health of the mother and the infant and should be avoided (van der Hoof 2002, Gruber 1998).

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TOPICAL USE ephedrine as a complement to preparations for local anesthetic, dermatologicals, stomatologicals or ophthalmologicals is compatible with breastfeeding (WHO 2002).


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Alternatives

We do not have alternatives for Ephedrine.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Ephedrine is also known as


Ephedrine in other languages or writings:

Tradenames

Main tradenames from several countries containing Ephedrine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 85 %
Molecular weight 165 daltons
VD 3 l/Kg
Tmax 0,25 - 1 hours
T1/2 3 - 5 hours

References

  1. Schalla SC, Witcomb GL, Haycraft E. Body Shape and Weight Loss as Motivators for Breastfeeding Initiation and Continuation. Int J Environ Res Public Health. 2017 Jul 11;14(7). pii: E754. Abstract
  2. Rodríguez JE, Campbell KM. Past, Present, and Future of Pharmacologic Therapy in Obesity. Prim Care. 2016 Mar;43(1):61-7, viii. Abstract
  3. López-Olmedo N, Hernández-Cordero S, Neufeld LM, García-Guerra A, Mejía-Rodríguez F, Méndez Gómez-Humarán I. The Associations of Maternal Weight Change with Breastfeeding, Diet and Physical Activity During the Postpartum Period. Matern Child Health J. 2016 Feb;20(2):270-80. Abstract
  4. Neville CE, McKinley MC, Holmes VA, Spence D, Woodside JV. The relationship between breastfeeding and postpartum weight change--a systematic review and critical evaluation. Int J Obes (Lond). 2014 Apr;38(4):577-90. Abstract
  5. Sámano R, Martínez-Rojano H, Godínez Martínez E, Sánchez Jiménez B, Villeda Rodríguez GP, Pérez Zamora J, Casanueva E. Effects of breastfeeding on weight loss and recovery of pregestational weight in adolescent and adult mothers. Food Nutr Bull. 2013 Jun;34(2):123-30. Abstract
  6. Havas F, Orhan Sungur M, Yenigün Y, Karadeniz M, Kılıç M, Özkan Seyhan T. Spinal anesthesia for elective cesarean section is associated with shorter hospital stay compared to general anesthesia. Agri. 2013 Abstract Full text (link to original source) Full text (in our servers)
  7. Hatsu IE, McDougald DM, Anderson AK. Effect of infant feeding on maternal body composition. Int Breastfeed J. 2008 Aug 6;3:18. Abstract
  8. Dewey KG. Impact of breastfeeding on maternal nutritional status. Adv Exp Med Biol. 2004;554:91-100. Review. Abstract
  9. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  10. van der Hooft CS, Stricker BH. [Ephedrine and ephedra in weight loss products and other preparations]. Ned Tijdschr Geneeskd. 2002 Abstract
  11. Dewey KG, Cohen RJ, Brown KH, Rivera LL. Effects of exclusive breastfeeding for four versus six months on maternal nutritional status and infant motor development: results of two randomized trials in Honduras. J Nutr. 2001 Feb;131(2):262-7. Abstract Full text (link to original source) Full text (in our servers)
  12. Gruber AJ, Pope HG Jr. Ephedrine abuse among 36 female weightlifters. Am J Addict. 1998 Abstract
  13. Dewey KG, Heinig MJ, Nommsen LA. Maternal weight-loss patterns during prolonged lactation. Am J Clin Nutr. 1993 Aug;58(2):162-6. Abstract
  14. Kramer FM, Stunkard AJ, Marshall KA, McKinney S, Liebschutz J. Breast-feeding reduces maternal lower-body fat. J Am Diet Assoc. 1993 Apr;93(4):429-33. Abstract
  15. Mortimer EA Jr. Drug toxicity from breast milk? Pediatrics. 1977 Abstract
  16. Pickup ME, May CS, Ssendagire R, Paterson JW. The pharmacokinetics of ephedrine after oral dosage in asthmatics receiving acute and chronic treatment. Br J Clin Pharmacol. 1976 Abstract

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